Thousands of patients with long-term conditions and dementia could benefit as GP contract proposals are unveiled

Thousands more patients are set to receive potentially life saving care as the Health Secretary, Jeremy Hunt today unveiled the Government's blueprint for changes to the GP contract.

The proposals will change the way GPs are rewarded for the care they offer. Instead of being rewarded extra for routine office functions like record keeping, GPs will be rewarded for steps which directly support and benefit patients. This includes better control of blood pressure and cholesterol, to prevent heart attacks and stroke and assessing patients at risk from dementia.

Millions of pounds will be switched into improving care for patients and making better use of taxpayers’ money. The proposed changes will see £164 million pounds taken away from rewarding GPs for bureaucratic tick box exercises and re-directed into actions which will directly benefit patients.

The changes could mean around 1.5 million more patients will get better care in 2013-14. This could reach as high as 3.5 million by 2014-15 and could help doctors go further in spotting early warning signs of illness. It should mean more tests, treatments and medicines for patients with diabetes, hypertension, lung disease, heart failure and arthritis - care that will improve diagnosis, the health of patients and potentially save more lives.

The proposed changes will see GPs rewarded for earlier diagnosis and better care of dementia patients and putting a sharper focus on improving the lives of patients with long-term conditions.

Health Secretary Jeremy Hunt said:

“Getting patients an earlier diagnosis of dementia and supporting those with long term conditions are my main priorities. I want GPs to take the lead in making this happen.

“Standards of care in this country must be world class - and we should continuously strive to improve. This is why the GP contract must change.

“Our proposals will make sure we support the patients most in need and will help save lives in practices across the country. We believe GPs can and will rise to these new challenges.

“We have listened to, responded to and fully considered alternative proposals put forward by the British Medical Association’s General Practitioners Committee. In the absence of an agreed settlement, it is reasonable to consult on the proposed changes needed to make sure improvements in patient care will follow.”

Standards of care are also being raised, initially in 20 clinical areas - for example relating to stroke or patients with heart disease - meaning more people have to be offered life improving, potentially life saving care. These higher standards will then be rolled out to other clinical areas in 2014 so that even more patients benefit.

The contract will also incorporate the latest expert advice on the areas which will have the greatest impact on patient health. This will include referrals to rehabilitation to allow people with lung disease to improve their health and quality of life as well as improved support for cancer patients and those with depression, arthritis and diabetes.

Notes to editors:

The British Medical Association’s General Practitioners Committee and other primary care organisations now have 12 weeks to respond to the Government’s proposals. A consultation on the changes was launched after a negotiated settlement could not be agreed following a series of discussions between the British Medical Association and NHS Employers.

Main new changes proposed in the consultation letter

The Minimum Practice Income Guarantee will be phased out over seven years as part of the contract.

Any overall increase in the value of GP contract payments, which will be decided following recommendations from the Doctors and Dentists Pay Review Body in February, will be distributed in a way that gives some increase to all GP practices but is targeted towards those with less current funding per patient.

All recommendations by the National Institute for Health and Clinical Excellence (NICE) for new and improved indicators to the Quality and outcomes Framework will be implemented in full.

QOF reward thresholds will be increased so that more patients benefit from the best evidence-based care that can help to save lives.

Organisational QOF payments will be discontinued releasing £164m which will be used to help fund improvements in patient care through the implementation of all the NICE recommended changes and the commissioning of extra services from GP practices.

It will stop some GP practices receiving thousands of pounds more than others that care for a similar number of patients with similar patient needs.

The extra services to be commissioned from GP practices will cover:

improving the assessment of people with dementia,

improving care management for frail older people and other high risk patients at risk of unplanned hospital admissions,

using technology to help monitor the health of people with long term conditions and improving online access to services.

This means GPs will be delivering more to retain the money they were getting under the old organisational indicators. The NHS Commissioning Board will develop more detailed specifications for these new schemes.

The Department of Health is proposing investment of up to £10 million annually (depending on take up) to GP practices for two new vaccination programmes for rotavirus and shingles.